Health Encyclopedia

Reverse Transcriptase Inhibitors

The human immunodeficiency virus (HIV) contains genetic information in the form of RNA. When HIV infects a human T cell, it must convert this RNA to DNA. It does so by using an enzyme called reverse transcriptase. Reverse transcriptase inhibitors interfere with this process.

The reverse transcriptase inhibitors lamivudine and zidovudine can cause damage to the mitochondria, the energy-producing subunits of cells. This may lead to symptoms such as lactic acidosis (a dangerous metabolic derangement),
peripheral neuropathy
(injury to nerves in the extremities), and lipodystrophy (cosmetically undesirable rearrangement of fat in the body). The supplement CoQ
10
has been tried for minimizing these side effects. In one
double-blind
, placebo-controlled study, use of CoQ
10
improved general sense of well-being in people with HIV infection using reverse transcriptase inhibitors; however, for reasons that are unclear, it actually worsened symptoms of peripheral neuropathy.
1
For this reason, people with HIV who have peripheral neuropathy symptoms should use CoQ
10
only with caution.

Use of the herb St. John’s wort can lower blood levels of numerous medications, including
protease inhibitors
used for HIV. Case reports indicate St. John’s wort also lowers blood levels of the non-nucleoside reverse transcriptase inhibitor nevirapine.
2
The bottom line: If you have HIV, do not take St. John's wort! Furthermore, if you have been stabilized on HIV medications while taking St. John's wort, if you stop taking the herb your blood levels of the drugs could rise, potentially leading to increased side effects.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.